Provider Demographics
NPI:1396117560
Name:KRAMER, WANDA CLARE (LMHC)
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:CLARE
Last Name:KRAMER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 MANHATTAN AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32118-3522
Mailing Address - Country:US
Mailing Address - Phone:407-516-1278
Mailing Address - Fax:
Practice Address - Street 1:9314 RANDAL PARK BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-4928
Practice Address - Country:US
Practice Address - Phone:407-516-1278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-27
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH11948101YM0800X
FLMH15662101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health